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Concept of Shotha W.S.R To Arishta Lakshana
Concept of Shotha W.S.R To Arishta Lakshana
Volume 8 Issue 1, January-February 2024 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
@ IJTSRD | Unique Paper ID – IJTSRD61332 | Volume – 8 | Issue – 1 | Jan-Feb 2024 Page 149
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
the toungue) and in this condition the patient will DISCCUSSION
ends up in death within three days(11). In a better way to understand the arishta lakshana that
is told by the acharyas lets compare with some of the
According to Susruthacharya, there are six types of
above said disease condition. In case of the right
shopha according to seventeenth chapter
sided heart failure due to the backflow of blood from
amapakweshaneeya and further details about the
venacava to the underneath blood vessel there will be
nidanas the other lakshanas asadhya lakshana of
swelling over the lower extremities as well as the
shopha etc are dealt with shopha chiktsa from chikitsa
umbilical region along with the hypertrophy of the
sthaana twenty third chapter. In chikitsa sthana
heart at the right side. This condition will cause at the
acharya is saying about kashta sadhya shotha and
end stage of the life and this can be correlated to the
arishtavath shopha(12).Here acharya says that
swelling that is seen in the lower limbs as well as
shwayathu that is affecting sarva shareera and
hridayardha shopha as arishta lakshana by the
shwayathu that is affecting sareera madhya can be
acharyas. In case of left sided heart failure there will
considered as kashta sadhya which means that the
be back flow of blood from the pulmonary vein
condition is difficult to treat(13).On this the
towards the lungs and there occurs congession and
commentary is giving reason that it is difficult to cure
swelling will arise over the upper parts of the body.
the like in case of sannipata jwara because of
This can be correlated as the arishta lakhasna that is
virudhopakrama(14).Then for arishtavat shopha
correlated to the upper part of the body and again
acharya is saying that these are the swelling that is
there also we can expect hypertrophy of the heart and
seen half part of the body(15).Also under the arishtavat
can be considered as hrudayardha shopha which is
shopha Susruthacharya have mentioned that the
said as a arishta lakshana by Susruthacharya. And in
swelling that is seen over the upper part of the body
the above condition itself the patient may have
which is spreading downwards in women and the
clinical features with cough and swasa due to the
swelling that is seen in the lower part of the body
congession of the lungs and this also substantiates
which is spreading to the upper part of the body in
that the shopha that is associated with the hikka,
males are considerd as arishta lakshana(16). Acharya
swasa can be considered as arishta lakshana.
also says that the shopha which is associated with
hikka (hiccough), atisara (diarrhoea), kasa (cough), In case of generalised oedema multiple system failure
will also kill the person(17). may happen where the liver may also get affected. So
if the liver is affected the protein production will be
According to modern science the pathogenesis of
reduced and there will be a decrease in the oncotic
swelling is as follows. It is caused by the mechanism
pressure which will leads to the production of
that interfere with normal fluid balance of plasma,
swelling all over the body and it may starts from the
interstitial fluid and lymph flow. The following
centre of the body because of the inflammatory
mechanism may be operating singly or in
reaction of liver there by leading to a condition called
combination to produce oedema(18):
ascites where we can expect the swelling at the centre
1. Decreased plasma oncotic pressure of the body. And all these changes will occur when
2. Increased capillary hydrostatic pressure the patient is nearing to the end stage. Acharya has
said that if the swelling occurs in the middle of the
3. Lymphatic obstruction
body then it is kashta sadhya due to virudhopakrama.
4. Tissue factors (increased oncotic pressure of Since multiple organs are getting affected here
interstitial fluid, and decreased tissue tension) treatment will be difficult and eventually the patient
5. Increased capillary permeability may land up in death.
6. Sodium and water retention CONCLUSION:
Diagnosis, prognosis and treatment are the core
We can see swelling as a feature that is occurring in clinical skills fundamental to good practice of
end stage of life. Some of the conditions are left sided medicine. Prediction of prognosis by the lakshana is
heart failure, right sided heart failure, kidney failure, very relevant for both the physician as well as the
liver failure, chronic ascites, AL amyloidosis etc. In patient. If the prognosis of the disease can be
general generalized swelling will occur in multiple predicted it would be easy for the physician to treat
organ failure because of the changes in the normal the patient and from the patient aspect they can seek
heamodynamics. In all the above conditions we can higher facility centre. In present era the prognosis is
observe the appearance of swelling over the body more focussed on the laboratory values. But now we
either localised or generalised depending upon the understood how acharyas have keenly observed the
condition which proves that whatever acharyas have prognosis of a disease with the help of lakshana only.
mentioned as the arishta lakshana is true.
@ IJTSRD | Unique Paper ID – IJTSRD61332 | Volume – 8 | Issue – 1 | Jan-Feb 2024 Page 150
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
So here we understood that the proper understanding 9. Vaidya javadji trikamji acharya Caraka Samhitha
of nidana panchaka that is nidan, poorvaroopa, roopa, sutra sthana chapter 18 Chowkamba orientalia
upashaya and samprapthi will help us to diagnose and reprint edition 2021 pp 107
to predict the prognosis as well as to treat a particular 10. Vaidya javadji trikamji acharya Caraka Samhitha
disease. sutra sthana chapter 18 Chowkamba orientalia
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sutra sthana chapter 18 Chowkamba orientalia 16. Vaidya Jadvji Trikamji Acharya and Narayan
reprint edition 2021 pp 106 Ram Acharya KavyatirthaSusrutha Samhitha
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reprint edition 2021 pp 106 Ram Acharya KavyatirthaSusrutha Samhitha
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sutra sthana chapter 18 Chowkamba orientalia 18. Harsh Mohan Textbook of pathology chapter 6
reprint edition 2021 pp 106 8th edition pgno169
@ IJTSRD | Unique Paper ID – IJTSRD61332 | Volume – 8 | Issue – 1 | Jan-Feb 2024 Page 151